Journal of women's health
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Journal of women's health · Sep 2019
Pre- and Early Pregnancy Onset Depression and Subsequent Rate of Gestational Weight Gain.
Background: Depression is associated with weight change outside of pregnancy. We assessed associations of prepregnancy or early pregnancy onset depression with gestational weight gain (GWG) rate overall and according to Institute of Medicine (IOM) recommendations. Materials and Methods: Depression from 6 months prepregnancy through 20 weeks gestation was identified in a health care system in northern California with perinatal depression screening (2011-2016; n = 87,600). GWG rate (lbs/week) was calculated using weight at delivery and at diagnosis or depression screening ≤20 weeks. Results: Compared to women without prepregnancy or early pregnancy depression, women with prepregnancy onset depression had 11% greater risk of GWG rate
IOM recommendations (95% CI: 1.01-1.05), with a stronger association for >IOM in normal weight women. ⋯ Women with early onset prenatal depression may be at slightly higher risk for GWG rate above recommendations. Our results suggest that the relationship between depression and GWG may vary based on timing of depression onset, prepregnancy body mass index category, and antidepressant use. Additional research should identify factors that predict how a woman's lifestyle behaviors and weight change after depression diagnosis. -
Journal of women's health · Sep 2019
Health Care Disparities Among U.S. Women of Reproductive Age by Level of Psychological Distress.
Background: Reproductive-age women have a high rate of contact with the health care system for reproductive health care. Yet, beyond pregnancy, little is known about psychological distress and unmet health care needs among these women. We examined reasons for delayed medical care and types of foregone care by level of psychological distress. ⋯ Cost is the greatest barrier to timely medical care for women with MPD and SPD. Conclusions: Women of reproductive age with psychological distress face considerable structural and cost-related barriers to accessing health care, which may be exacerbated by their psychological state. Despite recent policy advances such as the Affordable Care Act, additional efforts by policymakers and providers are crucial to address the needs of this population.
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Journal of women's health · Sep 2019
Pornography and Heterosexual Women's Intimate Experiences with a Partner.
Background: Pornographic media characterized by discordant images of sexual pleasure and aggression are increasingly formulating young heterosexual women's sexual scripts. Yet there has been little work done on the downstream role of pornography consumption; how does pornography use relate to heterosexual women's thoughts and feelings during sexual experiences with a partner? Methods: We surveyed 706 heterosexual women (18-29 years of age) in the United States, associating consumption of pornography with sexual preferences, experiences, and concerns. Results: Although most heterosexual women have seen pornography (83%), a little less than half (43.5%) use it for masturbation, half of whom use it one time per month or less. Among female consumers who were sexually active, higher rates of consumption for masturbation were associated with increased mental activation of the pornographic script during sex-heightened recall of pornographic images during sex with a partner, heightened reliance on pornography for achieving and maintaining arousal, and a preference for pornography consumption over sex with a partner. Furthermore, higher activation of the pornographic script during sex, rather than simply viewing pornographic material, was also associated with higher rates of insecurities about their appearance and diminished enjoyment of intimate acts such as kissing or caressing during sex with a partner. Conclusion: These findings suggest that pornography consumption may relate to female consumers' sexual experiences indirectly and indicate that pornographic thoughts during dyadic sexual encounters may not improve heterosexual women's sexual experiences with a partner.
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Journal of women's health · Sep 2019
Using Inside Knowledge Campaign Materials to Improve Gynecologic Cancer Knowledge in Underserved Women.
Purpose: About 30,000 U. S. women die each year from gynecologic cancer, which disproportionately affects underserved and minority populations. This project aimed at increasing and assessing awareness of risk, symptoms, and recommended screenings and prevention activities in underserved women, through unique collaboration between the Centers for Disease Control and Prevention's (CDC) Inside Knowledge (IK) campaign, which was designed to educate women about gynecologic cancer, and the CDC's national network of organizations to reduce cancer-related disparities. Materials and Methods: CDC's national network and the IK campaign partnered to deliver tailored educational sessions about gynecologic cancer to three populations of women served by the participant organizations. ⋯ Pre- and post-session questionnaires were administered to assess knowledge changes. Results: Knowledge changes for risk factors, screening, and HPV vaccination varied by network organization, but all sessions increased correct identification of some symptoms. Baseline knowledge also varied among organization participants. Conclusions: Sessions were effective in increasing awareness of gynecologic cancer among underserved women; however, organizational information uptake differed. Additional resources containing specific interventions appropriate to particular underserved populations may be beneficial in increasing healthy behaviors, leading to a reduction in gynecologic cancer disparities.
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Journal of women's health · Sep 2019
Strategies to Promote Postpartum Visit Attendance Among Medicaid Participants.
Background: Postpartum care is important for promoting maternal and infant health and well-being. Nationally, less than 60% of Medicaid-enrolled women attend their postpartum visit. The Strong Start for Mothers and Newborns II Initiative, an enhanced prenatal care program, intended to improve birth outcomes among Medicaid beneficiaries, enrolled 45,599 women, and included a variety of approaches to increasing engagement in postpartum care. Methods: This study analyzes qualitative case studies that include coded notes from 739 interviews with 1,074 key informants and 133 focus groups with 951 women; 4 years of annual memos capturing activities by each of 27 awardees and 24 Birth Center sites; and a review of interview and survey data from Medicaid officials in 20 states. Results: Strong Start prenatal care included education and support regarding postpartum care and concerns. ⋯ They also identified ongoing barriers to postpartum visit attendance. Conclusions: Postpartum care is essential to maternal and infant health. Medicaid enrolls many high-risk women and is the largest payer for postpartum care. Using lessons from Strong Start, providers who serve Medicaid-enrolled women can advance strategies to improve postpartum visit access and attendance.